JMIR Publications

ABSTRACT

Background:

Obesity and dental decay are linked through poor diet. In the U.S., >13% of 2-to-5-year old's have obesity and >21% have tooth decay, with highest rates in Black and Latino children and those from low-income families. Conflicting information, barriers, and lack of access to healthy food and dental care influence risk of poor diet and insufficient oral hygiene. Of interest is if leveraging technology can deliver tailored and motivational interventions to promote healthier diet and oral hygiene behaviors in young children of high need families.

Objective:

To determine the acceptability and usefulness of an online motivational interview (MI) and goal-setting session to improve healthy feeding and oral health in young children, and to determine how an initial survey with tailored messages informs the session to improve efficiency and effectiveness of the goal setting.

Methods:

Low-income caregivers of children ages 2-6 were recruited through multiple community agencies. The caregivers completed an online nutrition and dental health survey that delivered 2-3 tailored messages to motivate or reinforce healthier target behaviors for their child. Caregivers reported the willingness to change the target behavior of the messages and were invited to participate in an MI session via an online videoconference application, facilitated by trained dietitians and dietetics students. The facilitators used the messages received by the caregiver and their willingness to change to inform the session. The facilitators also used principles of MI to provide evidence-based recommendations, address barriers to these recommendations, and determine feasible goals with participants.

Results:

Of 142 caregivers who completed the initial survey, 83 indicated interest in the MI session and were contacted. 48 MI sessions were completed (41/48 female, 24/48 non-Hispanic White). Caregivers were willing to try to make 62/64 of the target nutrition behavioral improvements from the initial survey. 24/40 caregivers who received a tailored message to improve a nutrition behavior set a goal based on that message during the MI session. The most common nutrition goals set involved increasing vegetable consumption (25/48), increasing lean protein consumption (8/48), and serving healthier snacks (8/48), highlighting target behaviors caregivers deemed most relevant. Of those who provided feedback on the MI sessions (n=41), most strongly agreed (scale from strongly agree to strongly disagree) the MI session was easy and convenient to attend (33/41), and the UConn nutritionist made them feel comfortable to talk about their child’s health (38/41), helped them think about why health changes may be important (32/41), and helped them set a goal for positive changes in their child’s health (34/41).

Conclusions:

Results indicate acceptability and usefulness of an online MI and goal setting session, and that an initial survey with tailored messages informed the goal setting session.